MEDICARE: VIA CHRISTI VILLAGE MANHATTAN, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	N081001	KS
2	314000000X	Skilled Nursing Facility	N081001	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100107790B	OTHER	KS	HCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528061124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIA CHRISTI VILLAGE MANHATTAN, INC.

Provider Business Mailing Address
First Line	:	2800 WILLOW GROVE RD
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2105
Country	:	US
Telephone Number	:	785-539-7671
Fax Number	:	785-539-9125

Provider Business Practice Location Address
First Line	:	2800 WILLOW GROVE RD
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-2105
Country	:	US
Telephone Number	:	785-539-7671
Fax Number	:	785-539-9125

Authorized Official
Title or Position	:	CEO
Name	:	ERIN SHADBOLT
Credential	:
Telephone Number	:	314-729-3500

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/23/2025

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